How We’re Personally Preparing Against The Coronavirus

Executive Summary

• Understanding the motivation of the officials trying to avoid stating a panic
• Steps to take BEFORE the coronavirus hits your area
• Steps to take AFTER it does
• Helpful resources (besides PP.com) for staying on top of the coronavirus threat

If you have not yet read Part 1: Coronavirus: What We Can Say Publicly & What We Can’t, available free to all readers, please click here to read it first.

Okay, here we are ‘behind the paywall’ where we can loosen the tie a bit and grant ourselves the freedom to speculate and connect dots that might only have a single thread between them.

The truth is: Adam and I are more concerned about this pandemic virus than we have publicly let on.

We’ve both stepped up our own preparations as a result, sincerely hoping these accelerated precautions won’t be needed in the end. I will sheepishly and gladly donate any useful stored food, etc to the homeless shelter if this all blows over as a big nothingburger for my community.

But you know what has me the most concerned right now? It’s the vast gulf between the official statements vs the official actions.

On the one hand, we have a cacophony of WHO, CDC and equivalent national officials in other countries saying that this isn’t really that big of a deal — that international travel even shouldn’t be limited.

On the other hand, we have emergency airlifts of nationals back to their home countries where they are being quarantined in military facilities.

We’re being told (sold?) that nCoV is “no worse than the flu”. And yet China has put tens of millions of its citizens under quarantine and 70% of its economy into a complete lockdown.

We have enough data to say that this virus is *definitely* worse than the flu. It’s simply not possible to hold the the idea that it isn’t, given the data. But that’s the party line right now.

Here’s the narrative being used at the hospital PP reader Lnorris works at:

Hong Kong’s leader Carrie Lam just announced that nCoV shows signs of “community outbreak” meaning it’s spreading within and among people who haven’t traveled to China.

Meanwhile global stock markets are surging, pretending as if there’s zero risk at all.

Each of these data points contradicts the other. In times like these I default to the data. I trust actions more than words.

You say this isn’t that bad but your evacuating people to military quarantine? I’m going with what the quarantine implies, thank you very much.

Put Yourself In Their Shoes

My interpretation of all this comes from putting myself in ‘their’ shoes. Let’s imagine you are a public health official and you’ve got the real data: this is an actual pandemic, the virus is really a bad actor, and it’s at least 10x worse than the flu. Maybe 100x.

There’s no stopping it either at this point, only slowing it down. It’s R0 is too high and, worse, it spreads asymptomatically. Worryingly, within the first few weeks it had already mutated into at least nine distinct strains. That means it could break either way – mutate into something more benign, or more harmful.

So, what would you do if you were in their shoes?

Well, you’ve got to balance the entire spectrum of public health. It’s true this is a dangerous virus and it could hurt or even kill large numbers of people. But that cat is already out of the bag (their words, not mine) which means that’s already a done deal. What’s left to control? What can you do that would have a positive effect on public health?

Next on the list has to be preventing limiting serious economic harm.

That’s a legitimate concern, of course. If millions of people lose their jobs that has an impact. If the economy blows up because it’s a fragile system of shadow banks and weak create that has to constantly be expanded, then there’s even the risk of a complete meltdown.

The effects of that if modeled would probably show even more dire outcomes than the virus itself.

So the decision might be made; “let’s contain this as best we can, but we cannot have people panicking, so let’s also downplay the risks publicly.”

Which means the public statements and actions won’t be lining up. Which is what we see.

In a very odd coincidence, it was only back in October 2019 that Johns Hopkins and the Gates foundation hosted a simulation exercise called “Event 201” which had a mysterious coronavirus outbreak caused by a fictional virus named “CAPS”

The CAPS virus—which Toner describes as a cousin of SARS, “but slightly more transmissible, like the flu, and slightly more lethal”—was presented as resistant to any existing vaccine, as scientists scrambled to come up with one. Citizens, meanwhile, were rioting over scarce access to the next best thing: a fictional antiviral known to treat some CAPS symptoms.

That scenario, Toner says, is utterly realistic. “We don’t have a vaccine for SARS, or MERS, or various avian flu viruses that have come up in the past decade,” he notes. “That’s because vaccine development is slow and difficult if there isn’t an immediate market for it.”

In the simulation, CAPS resulted in a death toll of 65 million people within 18 months—surpassing the deadliest pandemic in history, the 1918 Spanish flu.

(Source)

Eerily close in every respect to what actually happened just a month or so later. Which means that the results of this very effective simulation were fresh on everyone’s minds.

The conclusions were these:

The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic exercise on October 18, 2019, in New York, NY. The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences.

Note that the prime conclusion was not “to limit the loss of lives.” It was to “diminish large-scale economic and societal consequences.”

In other words: It’s the economy stupid.

It’s Time To Prepare On Our Own

That’s fine, we suppose. That makes sense at the macro scale. However, there’s still room for you and I to decide for ourselves how we want to respond, in our own lives and in our own communities.

Let the macro players do what they must, but always understand their aims and your personal health may not be aligned.

The World Health Organization (WHO) made its position clear even as recently as yesterday, once again chiding countries for limiting air travel with China. In fact the WHO has made more statements about NOT doing things that might harm travel and trade than they have issued anything remotely useful towards helping you understand and avoid contamination.

Let them do their thing, while you do yours.

That leaves the big question: What to do?

To address that, Adam and I put together the guidance below, which is based on the steps we are taking in our own lives, with our own health, with our own families, in preparation should the coronavirus outbreak arrive where we live.

To make it easier to digest, we’ve categorized our recommendations into two large buckets:

1. Steps to take BEFORE the virus hits your community
2. Steps to take AFTER

There’s a lot of useful and specific information below. But if you have any suggestions/solutions to add that will make this resource more comprehensive and valuable for PP readers, please share your insights in the Comments section below.

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BEFORE The Virus Hits (Preventative Measures)

Protect & Boost Your Immune System

The best defense against a virus is to not expose yourself to it.

The three best ways to accomplish this are:

1. Isolation from the infected
2. Good hygiene practices
3. Good health

Isolation

This is your highest success strategy against a pandemic. Think remote cabin in the woods — one only you and your immediate family hunker down in for weeks. No contact with the outside world.

That will work great.

But as that’s not an available option for 99.9% of us, what are good strategies for those remaining at home and (for time being) still going to work?

1) Minimize your number physical interactions – Identify the demands on you to be around other people during your day — going to the office, buying groceries at the store, picking your kids up at school, etc. How many of these can you rejigger to minimize physical contact?

Will work let you telecommute? If not today, can you work out an arrangement with your boss that at the first announcement of a coronavirus infection in your city/town, you’ll immediately switch to working from home? (And if your request is rebuffed, consider making it a demand. HR will not have much of a leg to stand on here.)

If affordable for you, start having groceries delivered to your home vs going to the store. Most grocery stores now offer this service, as do many online companies like Instacart, HelloFresh, Peapod, Shipt, Amazon Fresh, and Walmart. Again, you may only decide to switch to this after the coronavirus is confirmed in your city. And of course, having a well-stocked deep pantry and/or producing some calories at home via a garden or livestock will help tremendously towards keeping your food uncontaminated.

• In Adam’s case, he’s re-joined a nearby CSA (Singing Frogs Farm) to ensure he’ll have uninterrupted access to farm-fresh produce without having to go to the grocery store. The vegetables are handled only by the farmer, and Adam can pick them up at the farm, likely not needing to interact with anyone. So the amount of human contact from soil to table is minimal.
• For inspiration and guidance on creating a deep pantry (as well as longer-term food storage), read our Food Storage wiki
• For help calculating how much food to store given the size and make-up of your family, the Church of Latter Day Saints (one of the greatest distributors of stored food on the planet) has a helpful calculator here.
• What medications do you depend on? Be sure to build ample stocks now, to have on hand later.
• Don’t forget to store water, too! (just in case) The rule of thumb is 1 gallon per person per day you plan to remain at home.

Schools are notorious for spreading diseases quickly. Once the virus is confirmed anywhere near your city, our advice is to homeschool until the all-clear is given by health authorities. It’s 2020, the golden age of digital devices and online learning — your kids should still be able to get most of their necessary instruction, assignments and coursework sent to them at home with little disruption. If it’s just for a few weeks, you’re kids will likely be happy for the change in routine (though you may be pulling your hair out by the end!)

• Don’t forget entertainment! Cabin fever, especially if you have children, is one of the biggest challenges to sheltering in place happily. Yes, your kids will probably be drawn to their devices for Instagram, Minecraft, etc, but also be sure to have “real world” interactive options on hand. Board games, parlor games, outdoor (but still on-property) sports, musical instruments, model building, yard projects, journaling, cooking together — and don’t forget the value of having meaningful conversations 

They key here is to dramatically reduce the number of times you come into physical proximity with a potentially infectious person or contact-surface germs of theirs (door handles, table tops, restrooms, etc)  during the day.

If you’re able to follow all of the above steps, it’s possible to reduce your exposure risk by 90%+.

Again, the best way to protect yourself from a potentially lethal virus is to avoid fighting it in the first place.

2) Isolate the infected (and the suspected) A.S.A.P!  — virus containment is critically dependent on swift and effective quarantines. While the heavily lifting on this is the purview of our public health authorities, you can play a big part in assisting their efforts.

If you run a business with employees, for those not telecommuting, make sure everyone knows NOT to come in to the office if they’re showing any symptoms. Make this a very clear, very firm rule. Advise them to stay at home and call their doctor for guidance on treatment.

What symptoms should you be on the alert for?

If any family member is showing flu-like signs, do NOT let them out of the house — especially to any place where they could infect others (work, school, shops, etc). Call the doctor for guidance, and treat at home if possible. At this point, you and all others in your home need to consider yourself possibly infected and should remain in home quarantine, too. Yes, it may be a drag and a huge inconvenience, but you’re doing your part in a bigger effort to keep the disease from spreading to many others. And if you’re already prepared by following the rest of the advice in this report, it really won’t be that bad.

Good Hygiene Practices

Hygiene is one of those semi-silly words we associate with our childhood. We remember our parents and teachers droning on about it, but mostly thought it was a lot of unimportant fuss.

Turns out, it’s not. It’s a stone-cold lifesaver if done properly.

The coronavirus spreads via droplets of bodily fluids (mostly saliva and mucus) and is most commonly transmitted by a contagious person coughing, sneezing and wiping their nose. Direct exposure to this, or coming into contact with a surface covered with infected droplets, are your biggest risk.

If you come into contact with virus particle, good hygiene practices are the best bet of keeping it from infecting you.

The most important practices against a coronavirus (per the CDC and W.H.O.) are:

• Wash, wash, wash your hands — do this frequently when in public places, especially before eating and after coming into physical contact with others (e.g., shaking hands) or shared surfaces (tables, doorknobs, etc). Both soap and water and alcohol-based hand rubs will kill the virus. We each carry a small bottle of hand sanitizer (active ingredient 70% ethyl alcohol) with us now, and use it liberally when out in public.
• Minimize touching your eyes, nose and mouth — These are, by far, the main entry points for the virus into your body. But man, controlling these habits is *hard* to do. We’re all so accustomed to doing it without thinking. But with a little focused self-awareness and discipline, you can train yourself out of these ingrained habits. Wearing gloves is helpful, as it helps make you more aware of your instinctive attempts.

And when in high risk areas, especially where you suspect contagious people could be:

• Maintain social distancing — as discussed above, distance is your friend. You can breathe in the virus if close enough to a contagious person who coughs or sneezes. The CDC recommends a minimum distance of 1 meter (at least 3 feet) from anyone you suspect may be infected.
• Cover your mouth with a mask — but not just any mask, it needs a small enough filter to keep the virus out. N95 respirator masks will do this. They used to be readily available, but are currently sold out at many online providers (like Amazon). If you strike out online, check stores in your local area for availability. Note that N95 masks must be worn properly to be effective. For instructions, click here.
• Wear gloves — cotton or latex gloves will act as a first line of defense, plus, as mentioned, they will make you more mindful about touching your mouth, nose and eyes. Note: your natural skin is an effective barrier against the virus, but gloves can help prevent virus particles from getting on your skin in the first place.
• Wear eye protection — regular eyeglasses or sunglasses are good; anything offering full wrap-around protection is even better.

And if you or anyone in your house comes down with flu-like symptoms:

• Self-isolate — the fewer people you’re around, the fewer you can potentially infect. DON’T go to work. DON’T take your child to school. DON’T go out to public places.
• Call your doctor immediately — get guidance on how to self-care as well as under what conditions you should go to see a professional health provider in person.
• Cover coughs and sneezes — Use your elbow or a tissue as a shield. Even better, wear a mask. A standard surgical mask will suffice (you don’t need an N95).
• Rest, hydrate and administer self-care — see Sand_puppy’s list below under “Be Prepared To Self-Treat”.

Good Health

If the virus makes it past your defenses and into your body, it’s now up to your immune system to kill it before it proliferates.

Which is why you want to give your immune system as much of an advantage as possible by getting and remaining in good health.

According to Harvard Medical School, here are the best ways to boost your immune system:

• Don’t smoke.
• Eat a diet high in fruits and vegetables.
• Exercise regularly.
• Maintain a healthy weight.
• If you drink alcohol, drink only in moderation.
• Get adequate sleep.
• Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.
• Try to minimize stress.

To this list we would add getting a high daily dose of vitamin C. Chris’ elderberry syrup recipe is a good source with other likely flu-fighting benefits.

Prepare Your Family Plan

What’s your plan? Do you have a ‘bright red line’ that once crossed will cause you and your family to undertake new actions? I think we’d all rather avoid being locked down in a city like so many tens of millions of Chinese.

That sounds positively stress inducing and awful.

My ‘bright red line’ is the first local case of nCoV in my community. This is when I will activate a much more rigorous program of social distancing and possibly even isolation if things get bad enough.

For Adam, upon the first announced case in the county where his older daughter is currently at college, he’ll give her the call to come on home.

What’s your bright red line?

Do you have a more remote place to go if you deem your current place inappropriate to ride out a storm? If you have that second place, what will your personal triggers be to tell you it’s time to go?

Our advice is to write these down right now. Put pen to paper and then tack that to the wall.

The trickiest thing in these situations is to not experience a ‘shifting baseline’ that creeps your bright red line along out in front of you so that you never cross it. Or at least not in time.

Events have a way of normalizing themselves in real time. Things that would have caused you to immediately spring to urgent action a month ago don’t seem all that bad today.

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AFTER The Virus Hits  (Treatment Measures)

Creating A Sick Room

If, or rather when, this pandemic arrives in your area, and you are located right where you are going to ride out the storm, for better or worse, then it’s time to create a sick room in your house.

Remember, ~97% of all people who get infected with nCov are going to survive. Maybe more – a lot more (99%?) – because we don’t have sufficient test kits being performed especially on people with mild symptoms, so it’s almost certainly true that cases are being under reported. It’s also true that deaths are being under reported, so there’s that too.

Regardless, we’ll let the statisticians and epidemiologists figure all that out at the end.

You’ll want a sick room in your house to isolate anyone with the flu or nCov to prevent them from spreading it more widely within your family or community.

Here’s what the CDC recommends:

That’s a good start, but we’ll go further.

You should put up plastic sheeting over any openings to the sick room to prevent virus droplets from escaping. If you can, place a small fan in an opening in the plastic blowing into the room. This will create positive pressure, and crack a window to allow that positive pressure air to escape.

Positive pressure is the key to all clean rooms, biosuits and sterile room hoods.

Whenever entering or exiting the sick room, follow all of the basic hygiene and protective wear advice from the other part of this report.

Next, have buckets of bleach water at the entrance/exit. Most infections of medical staff during SARS were thought to occur during the doffing of their PPE. After carefully and thoughtfully removing your PPE dip your hands in bleach water and allow them to air dry. Step into a tub of bleach water, or spray well with a bleach solution in a spray bottle and out onto a clean surface. Also allow to air dry.

Be Prepared To Self-Treat

Luckily at Peak Prosperity our tribe is loaded with skilled talent. Member Sand Puppy has had a long career as an ER doctor.

His advice? If this thing comes around, you should be ready to treat at home — only going to the hospital when absolutely necessary (conditions noted below).

This will help prevent the hospital from becoming overwhelmed. And it will help you avoid being exposed to a lot of other sick people.

Home treatment of febrile Influenza Like Illnesses/Respiratory Infection

During outbreaks of viral illness, the ER will be a madhouse. Stay away if possible.  Recommend strong attempts at self-treatment at home.  Stay out of the hospital unless truly needed.

• Ibuprofen 800 mg (or naproxen) for fever, body aches, headache, chest wall soreness. This is a miraculous drug for the misery of ILI. It also helps to sort out the miserable from the seriously sick (see below).
• If not vomiting repeatedly, you can drink water. “Drink until you pee.” Lots.
• Electrolytes in water if diarrhea is a part of fluid losses.
• If incessant coughing, Nyquil or equivalent.

The hospital ED will be a miserable place during a flu epidemic.  Long waits, no pillows or blankets. No snacks.  No sympathy from the staff!!  Sleeping on the floor of the hallways.  Remember that the ED staff is probably sick also.

A few situations where hospital care IS needed.

1. Intractable vomiting (>6-8 times) or vomiting with diarrhea. IV fluids and anti-emetics will help when not able to hydrate by mouth.
2. Chest pain and shortness of breath with fever, IF associated with fast pulse and low oxygen saturation. Might be pneumonia. Chest x-ray. Supplemental oxygen if oxygen is actually low. Measure pulse rate an oxygen saturation (see below).  In children, fast breathing at rest, even after good fever control, points towards pneumonia.
3. Severe headache even after big doses of Ibuprofen and hydration. Might be meningitis. Spinal tap needed. IV antibiotics might help. Don’t even think about spinal tap until ibuprofen dose has been in body for 2 hours—everyone with the flu has a terrible headache.
4. Urinary symptoms. UTI can give a ILI, especially in children and women.
5. Wheezing with cough. May have an asthma-like response to the infection. Albuterol (and maybe steroids) may help. Uncommon.

Equipment list for home treatment of ILI:

• Costco sized bottle of Ibuprofen or Naproxen. (Use the big dose)
• Watch with second hand to measure pulse rate and respiratory rate.
• Pulse oximeter, $29 from Walmart or Amazon. This device will save you an ED trip.  Recommended!  Pic below.
• Big tumbler for water.  Drink and refill often.
• Electrolyte powder (mag and K) in water if have diarrhea.
• Disinfectant wipes.
• 

General Immune system support as outlined by many above (vita c, vita D3, plant antioxidants, Zn, Se, N-Acetyl cysteine, etc).

Q: What is the etiology of my ILI/URI?

A: It doesn’t matter. Treatment approach is the same.

—————–

Lots of bugs cause ILI/URI.  Most treated the same way. One example.

(Source)

Proper Donning & Doffing Technique

When caring for someone with flu symptoms, it’s crucial to wear Personal Protection Equipment (PPE). Mask, gloves, eye protection, and a gown or other kind of body covering. Collectively, this is your protective shield against pathogens.

Like all equipment, there are better and worse ways to use it.

Putting it on effectively (‘donning’) and taking it off (‘doffing’) are essential for PPE to be effective.

The basic rule I follow is that the outside of any PPE is not-sterile and possibly contaminated. So I think of it was being coated in used motor oil and that I am wearing a very expensive, unstained, bright white suit.

My goal is to not get a single drop of oil onto that suit.

That’s a good place to start. There’s also a correct sequence to follow. Again, from the CDC:

Key Sites To Stay Updated

We are doing our level-best to scour all the news and data available on the Wuhan coronavirus and distill the important elements for you in our daily videos, articles & podcasts.

That said, we know many of you are hungry for more.

While waiting for the next Peak Prosperity report to come out, you may find these online resources to be helpful in expanding your understanding of the developing situation.

We check a LOT of sources daily. But these are some of the most generally useful/user-friendly:

• Wuflu.live — data tables and charts showing # of infected/dead/recovered. One of the first sites updated when new official data is released
• Johns Hopkins tracker — summary data & maps visualization of official data
• 2019-nCov Global Cases Summary Report — yet another data tracking & visualization resource
• The Guardian coronavirus live coverage — breaking news stream
• South China Morning Post News Coverage — news with a greater Asian perspective (where the vast majority of the outbreak currently is)
• WHO.int — daily situation reports from the World Health Organization
• CDC.gov — Center for Disease Control 2019 Novel Coronavirus Home
• The Lancet — the latest medical research on ncov2019
• Map of US confirmed infected, by state

The Urgency of Action

One of the refrains we repeat most often at Peak Prosperity regarding major crises is: It’s far preferable to be a year early with your preparations than a day late.

That wisdom is more relevant when it comes to pandemic than most any other threat we know of.

The cost of being a day too late is VASTLY higher than being early. At best, you can’t get the supplies you need because the panicked masses have picked the store shelves bars. At worst, you’re already infected.

Why put yourself needlessly at risk?

Get started TODAY on the steps laid out above. At best, the virus never even comes near your neck of the woods. At worst, it does, and you’re as ready for it as you can be.

cheers,

Chris & Adam

 

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